Abstract: Objective To investigate the clinical value of shear wave elastography (SWE), transient elastography (TE), and the aspartate aminotransferase-to-platelet ratio index (APRI) in assessing the severity of esophagogastric varices (EGV) in patients with liver cirrhosis. Methods A total of 128 patients diagnosed with liver cirrhosis and confirmed to have EGV by endoscopy in Anyang District Hospital of Puyang City between January 2022 and December 2024 were enrolled in this study. Based on the finding of endoscopic examination, the patients were divided into a mild group (n=61) and a moderate-to-severe group (n=67). All patients underwent SWE, TE, and serological tests within one week prior to endoscopic examination. Liver and spleen elasticity parameters and APRI values were recorded. The correlations of them with EGV severity were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of the combined model. Results The liver mean values of elasticity (liver Emean) [(28.03±10.15) kPa], liver maximum values of elasticity (liver Emax) [(49.78±11.65) kPa], spleen Emean [(55.15±8.77) kPa], spleen Emax [(80.45±10.54) kPa], liver fibrosis index (LF) Index[(3.02±0.23)], spleen LF index [(3.32±0.71)], spleen stiffness [(16.55±3.21) kPa], and APRI index [(3.51±0.56)] levels in the moderate-to-severe group were significantly higher than those of (20.66±5.68) kPa, (37.15±8.77) kPa, (33.46±9.41) kPa, (49.78±12.69) kPa, (2.92±0.24), (2.91±0.88), (11.12±2.65) kPa, (2.02±0.55),in the mild group [P<0.05]. Spearman correlation analysis showed that these indicators were positively correlated with EGV severity. ROC analysis demonstrated that a combined diagnostic model incorporating indicators with AUC>0.750 (including liver Emax, spleen Emean, spleen Emax, spleen stiffness, and APRI) yielded an AUC of 0.930. Conclusion The diagnostic model constructed using SWE, TE, and APRI can effectively assess the severity of EGV in patients with liver cirrhosis with high diagnostic performances, which may provide a noninvasive reference for pre-endoscopic stratification.

Key words: Liver cirrhosis, Esophagogastric varices, Shear wave elastography, Transient elastography, Aspartate aminotransferase-to-platelet ratio index